Nikki Boudreaux repeated the names out loud 10 times, 100 times. More. Todd, Jack, Ashley, Courtney.
Before doctors cut into her skull to remove a golf ball-size portion of her brain, Boudreaux repeated the cadence: Todd, Jack, Ashley, Courtney. Todd, Jack, Ashley, Courtney.
An occupational therapist for more than two decades, the woman with the iron will knew recovery from her stroke – and nine-hour brain surgery – would be much more difficult than the Half Ironman she completed 10 days earlier. Though it would take time for her body to heal, she wanted her brain to remember one thing – the names of her family members – so she kept repeating the names of her husband of 20 years and their children in order of their ages.
“If I was going to forget anything,” she said, “I was going to remember my family’s names.”
Saturday marked the anniversary of Boudreaux’s arteriovenous malformation rupture, a brain hemorrhage she miraculously survived. She will celebrate her life Sunday when she competes with Todd in the ESi Ironman 70.3 Augusta. Nikki will open the race with a 1.2-mile swim, Todd will bike the 56 miles and Nikki will finish the 13.1-mile run.
“It was quite an ordeal,” Todd Boudreaux said. “She feels like she’s got a good part of her life back.”
Life seemed normal for the Evans couple after they competed in the 2011 Augusta Half Ironman. They met each other in the mid-1980s at Alleluia Community School and their relationship remained strong after graduation. She graduated from the Medical College of Georgia. He graduated from the University of Georgia’s law school.
They soon got married and had their first child, Jack. After a brief stay in Macon, Ga., they returned to Augusta.
Starting to race
For years, each remained in good shape, working out at the gym and attending fitness classes. Nikki stayed busy with her job and shuttling her children around town. Three years ago, before she turned 40, Boudreaux participated in her first Augusta Half Marathon.
Months later, Nikki’s neighbors mentioned wanting to compete in the 2010 Augusta Half Ironman. They needed a runner, and she quickly accepted. Then, Todd decided to put in a team eight weeks before the race. Nikki’s team won against her husband’s team.
A year later, Nikki and Todd each decided to compete in the entire race. They learned how to swim. They bought their own bikes. Their races went well – Nikki finished at 6:35:47, while Todd came in at 6:55:18.
On Wednesday after the race, Nikki went to the doctor for a routine checkup. She walked out of the office with no problems detected, but, then again, she had never had any health issues.
The next day, she went to a fitness class. Normally clumsy, she noticed 45 minutes into the hour-long class her coordination was much improved. Then, her head began hurting. She became light-headed and dizzy. She walked into the main part of the gym to get some air. Her friends grabbed a doctor, who happened to be working out. He asked her some basic questions: What’s your name? What day is it? Who’s the president?
She couldn’t respond. He called for an ambulance.
“I remember sitting there touching my head and I had a horrible headache. My head was killing me,” she said. “I remember people saying things. I remember people asking me questions. I don’t remember anything after that point.”
At the hospital
The 42-year-old Boudreaux was taken to Doctors Hospital emergency room. In the ambulance, she said, “I’ve got to finish this race.” In her mind, she was competing in the Half Ironman. She still had one more lap to go.
At the hospital, a CT scan revealed the AVM rupture – massive bleeding on the brain. Doctors gave her anti-inflammatory medicine to reduce the swelling and get her stabilized. She was taken to University Hospital, where doctors waited to let her brain recover from the initial trauma while the medication worked. In the week leading up to surgery, she began to improve. She regained some feeling on her right side. Her vision in her right eye became clearer. Her speech became better.
When it came time for surgery, there were no guarantees she would emerge with improved mental and physical faculties. In the waiting room the day of the surgery, Nikki waited with head pain and a cold towel on her face. Then, she began reciting the names: Todd, Jack, Ashley, Courtney.
Doctors worked nine hours to remove the AVM, extract a blood “ball” that had formed and remove a large portion of brain tissue that became damaged when the bleeding occurred. The surgery was a success, and the day after Nikki recalled the names she repeated before undergoing the procedure.
Todd, Jack, Ashley, Courtney.
After surgery, the Boudreauxs were told she would spend a month in intensive care before spending another month in a regular hospital room. Then, she would spend six months in an inpatient rehabilitation facility.
Three days after surgery, she got out of bed and walked laps around the floor. She continued walking every day with someone holding her IV bag. She even fed herself, grabbing her right hand with her left arm, forcing it to work. The physical therapists soon told her they were of no more help.
One week after surgery, she defied the odds. While she still needed speech therapy, Boudreaux was released to go home. Much of her recovery was attributed to being in peak physical condition.
Before she left the hospital, she said she was going to participate in the 2012 Augusta Half Ironman, and she didn’t back down.
“I just knew,” she said, “this was going to help me get myself back together.”
For about five months, she needed someone with her 24 hours a day. Eventually she began taking walks around the neighborhood and the Augusta Canal. Two months after surgery, her doctor approved her to participate in a spin class at the gym.
In follow-up appointments, Nikki kept asking for clearance to compete in this year’s Half Ironman. She kept getting rejected. Six months after surgery, she and Todd presented one final proposal: What if she swam, Todd biked and she ran? She received the OK.
Today, she will compete.
“It’s a personal goal for this year,” she said. “This one is a celebration, because I lived.”
She has almost fully recovered from the incident. She has lost some sight in her right eye. Her speech has recovered, though she sometimes has trouble finding the right word. She still has a little weakness on her right side, but for the most part she’s back to full strength.
“Had she not been in as good as condition as she was – the best shape of her life – she would not have recovered as well as she has,” Todd Boudreaux said.
The cause of the AVM remains uncertain. She said she was fortunate to be at the gym when this happened. Had she been home alone or driving down the road, she might not be here today.
“What if she were somewhere where they hadn’t immediately sent her to the hospital?” her husband asked. “What if this would’ve happened during the Ironman and the medics would’ve thought she was just dehydrated and exhausted? It’s frightening to think of all those ‘what if’ scenarios.”
At first, speculation was the AVM was caused because of Nikki competing in the Half Ironman. Her neurologists said if that had been the reason, it would’ve occurred during the race.
As soon as registration opens for next year’s competition, Todd said she’ll be one of the first signed up. Nikki added it’s “killing” her not competing in all three legs of the Half Ironman this year.
“I will be here every year,” she said. “And I will do the entire thing. I won’t do a relay again.”
When she completes her run Sunday, expect family and friends to be waiting at the finish line. While Nikki Boudreaux has many friends in the Augusta area and many in the triathlon community, it’s the four closest to her heart she treasures most.
Todd, Jack, Ashley, Courtney.
“I’m very grateful I have my wonderful kids and my husband,” she said. “This hasn’t hampered my spirit. I’m still very happy.”